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General NPI Number Information
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NPI Number | 1750459616
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Entity Type | Individual
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Provider Name | MICHAEL A COSGROVE M.D.
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Gender | Male
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Dates
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Enumeration Date | 11/30/2006
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Last Update Date | 08/29/2023
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Provider Practice Location Address
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Address Line | 201 GOVERNORS DR SW STE 400
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City | HUNTSVILLE
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State | AL
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Zip | 35801-5183
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Country | US
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Telephone | 256-265-7246
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Fax | 256-666-8655
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Provider Business Mailing Address
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Address Line | PO BOX 242848
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City | MONTGOMERY
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State | AL
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Zip | 36124-2848
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | EC-05-009
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License Number State | ME
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Taxonomy #2
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | MD29603
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License Number State | AL
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Taxonomy #3
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Taxonomy Code | 207LP2900X
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Taxonomy Name | Pain Medicine (Anesthesiology) Physician
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License Number | C1-6125
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License Number State | DE
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Taxonomy #4
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Taxonomy Code | 207LP2900X
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Taxonomy Name | Pain Medicine (Anesthesiology) Physician
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License Number | 22757
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License Number State | MS
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Taxonomy #5
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Taxonomy Code | 207LP2900X
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Taxonomy Name | Pain Medicine (Anesthesiology) Physician
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License Number | 29603
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License Number State | AL
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